New OB Nurses, Grads and Students, Please Feel Free to post your questions here:

[SmilingBluEyes]

Mugwump had a great idea offering services to new grads as a mentor (thank you for that!)

So, I thought having a "sticky" for new grads, OB nurses, students, and others with questions who want to post these can do so here. We also seem to see many of the same questions over and over, so perhaps this would help serve as an ongoing discussion of common issues/questions we all seem to have on our minds. This could serve not just for those asking directly, but others who may be "lurking" and looking for information or considering a career in OB, newborn, GYN nursing, or midwifery, doula services, childbirth education, lactation consulting, or other related work.

So if any mod thinks this is a good idea, mind stickying this?

Let's give this a go and see how it works out. We have many potential "mentors" here among us who, I am sure, would LOVE to help a new nurse/midwife/doula or student on his or her way to a rewarding career. I know I would love to help out!

[Elvish, BSN, DNP, RN, NP]

thx for the reply. yea at clinicals there is not a spot for it on their assessment forms, and their inital assessment just check circulation/ pulses X 4 extrem. At what age on a child is the approiate age for a bp? understanding if done, bp cuff on leg, right? this is just from curitosity bc i dont have kids, so i dunno. plus we have to know normals for newborn, 1yr, 2yr, 3yr, etc , and being a hands on type of person, i wondered when is it okay to start BP. kinda funny you need to know all the b/ps but dont really take it.

I know curitosity killed the cat, sometimes when you start putting all the information together, something dont click. it kinda difficult to put it all together when your not sure actually when to do it, but you know the numbers. lol

It's appropriate to do BPs on a newborn if you suspect something wrong.

Example: we had a newborn whose femoral pulses couldn't be palpated. I couldn't find them, the nurse practitioner couldn't find them. She ordered BPs on all extremities to help rule out coarctation of the aorta. (Look that one up in your peds book, it is very interesting.) They were all normal.

My point is that there isn't an age when all of a sudden a BP on a newborn/infant becomes magically appropriate. It is a case-by-case thing based on your assessment findings and critical thinking....don't you love that phrase?? It really is key.

[hrobrnc]

Hi all,

We do BP's on all newborns as part of their initial assessment. Another hospital I worked in, does not. I guess it is facility dependent. How accurate it is, I'm not sure.. If anyone can answer that , please do. I work strickly labor and delivery and we have nursery nurses who come to every delivery. :typing

[Reddy,RN]

Hi all. I'm studying for NCLEX and came across this article about cerebral palsy and MgSO4.

It sounds amazing to me. I'm wondering if expxerienced O-GYN nurses are familiar with this.

Thanks.

"Epsom salt can prevent cerebral palsy: U.S. study

...

Magnesium sulfate, popularly known as Epsom salts, cut the rate of cerebral palsy in half, Dr. John Thorp, a professor of obstetrics at the University of North Carolina at Chapel Hill, and colleagues reported.

"We have a cheap, widely available treatment already in hand that cuts in half the risk of babies being born with an extremely disabling disorder," Thorp said in a statement.

"And virtually every delivery room in the United States is already stocked with magnesium sulfate solutions that are given to pregnant women during childbirth for other reasons."

... "

http://www.reuters.com/article/healthNews/idUSHUN17633820080131?sp=true

[nursewho]

Just dropping to say hi...I am a relatively new RN having graduated 2 years ago. I just finished two years on a Med-Surg floor, and making a transition to post-partum nursing in 1 week. I am both excited and nervous about making this change. Glad I found this thread...I'm sure I'll be checking in often.

[Lilluv117]

thx for the reply. yea at clinicals there is not a spot for it on their assessment forms, and their inital assessment just check circulation/ pulses X 4 extrem. At what age on a child is the approiate age for a bp? understanding if done, bp cuff on leg, right? this is just from curitosity bc i dont have kids, so i dunno. plus we have to know normals for newborn, 1yr, 2yr, 3yr, etc , and being a hands on type of person, i wondered when is it okay to start BP. kinda funny you need to know all the b/ps but dont really take it.

I know curitosity killed the cat, sometimes when you start putting all the information together, something dont click. it kinda difficult to put it all together when your not sure actually when to do it, but you know the numbers. lol

I worked in the ER as a PCA for a while during nursing school and at that facility we only did routine BPs on children over the age of 5... Of course if a problem was suspected and we needed to do a BP they did it. But as a routine VS, it was over 5 years old. I don't know if that helps.

[KT-Jay731]

I am a new grad (and new RN as of yesterday!!!) and at our facility we do BPs on all newborns per our policy.

Now my question: Is there a difference between belonging to your state division of AWHONN or the national organization?

Thanks!

[Elvish, BSN, DNP, RN, NP]

Now my question: Is there a difference between belonging to your state division of AWHONN or the national organization?

Nope. You send your dues to the headquarters in DC and you're a member of the nationwide organization which has state/local chapters that meet every so often.

[cubbynurse]

Hi everyone-

I am going to be starting as a RN on a high risk antepartum/postpartum floor in 2 weeks and am reviewing common medications given on the floor. I have been a nursing assistant on the floor for my last year of school and know that many of the patients are started on birth control if they want it prior to discharge.

-Is depo-provera ever given if the mother is going to be breastfeeding? It says use with caution if lactating. Would any hormonal birth control be used for a breastfeeding mother?

-It also lists thromboemolism/ pulmonary embolism as a life-threatening complication of this medication....which confused me. I thought that estrogen was what caused clots to form and if depo-provera does not contain estrogen, how is this a side-effect of it?

-My book says it comes in both PO and oil suspension...how often is the PO form used in the postpartum setting?

I'm sorry if some of these questions seem kind of silly Thanks in advance!

I am using the 20th Anniversary 2007 Mosby's Nursing Drug Reference if that helps anyone.

[Jolie, BSN]

-is depo-provera ever given if the mother is going to be breastfeeding? it says use with caution if lactating. would any hormonal birth control be used for a breastfeeding mother?

in my experience, most obs and cnms want their patients to establish breastfeeding before starting hormonal contraceptives. i can't recall a breastfeeding mom being started on these medications in the immediate post-partum period (while in the hospital). it is not uncommon for them to be instructed to avoid intercourse until their 6 weeks pp check-up, at which time contraceptives are started, since breastfeeding is well-established by then.

-it also lists thromboemolism/ pulmonary embolism as a life-threatening complication of this medication....which confused me. i thought that estrogen was what caused clots to form and if depo-provera does not contain estrogen, how is this a side-effect of it?

not sure about this one :) i'd have to look it up.

-my book says it comes in both po and oil suspension...how often is the po form used in the postpartum setting?

provera is available in a number of forms. however, "depo" refers to a long-acting injectible form. depo-provera is an im injection given approximately every 3 months. the oral form of provera is not a contraceptive, to my knowledge, but is used as hormone replacement therapy. the oil suspension of provera is a short-acting form used as progesterone replacement.

i'm sorry if some of these questions seem kind of silly thanks in advance!

no question is silly! enjoy your new job!

[UPanRUNNIN]

OK I probably should not answer this as I havent even reached the RN level yet. But I can speak from experience. After I had my second son while still in the hospital I received the depo provera shot. I had a c-section and was there for 4 days, I received the shot on the 3rd day. And I was breast feeding. I would hope that especially with a c-section if there was a risk of clotting they would not have given me the shot. Maybe if the patient is in good health and had no complications on previous labor and postpartum recovery it is just a call the DR. makes. I dont exactly know, but thats what happened to me and thought Id share it. Like I said I am not yet an RN, still in school.

[Poopsie Gigglebuns]

Can someone give me some good references on the ins/outs of using pit? as a new nurse, i'm getting conflicting info. some say ctx should be 250 mvu and 1.5 min apart - others say different. some rns have increased dosage even after 1 or 2 lates. some increase even if we haven't been getting good info from toco/cardio b/c patient is too fat. also, some say turn pit off if patient has been on overnight and is not progressing(receptors saturated); others say you should turn it up when this happens. policy of hospital pretty much says do what MD prescribes. i don't know enough to step in and say not a good idea. all my drug book says is CI and AE, which is pretty much useless. So confused!!!

[flipflop239]

Hi! i have a question, i am goin gto the university of central florida this fall with a pre-nursing major to get my BSN in nursing. I want to work in labor/delivery, but dont mistake me, i dont want to be a midwife, but how long does it takeonce you get your BSN to get into that program and working in the hospitals working in L&D? is there a program i have to go thru after the i get my BSN?? thanks so much, i just want to know what my path is for me and what i should plan for, im so excited!